This research is intended to study the mother-child interactional patterns and attachment behaviors of children with varying degrees of congenital craniofacial anamoly (CFA) during infancy and early childhood. The general aim of this proposed 3-year project is to describe the developmental progression of interactional behavior as it relates to; a) child characteristics including cognitive functioning, temperament, and facial/medical variables (e.g. degree of disfigurement, feeding problems) and b) parent/ family/ecological characteristics including marital adjustment, psychological functioning, social support, and family environment. This will be accomplished by directly observing the interactions of 120 mother-infant dyads (60 impaired infants and 60 non- impaired) at three age periods(2.5,12, and 24 months) in structured feeding, and teaching, free-play situations, and separation/reunion tasks. The objectives of this study are; 1) To provide descriptive information regarding the above variables in relation to different subgroups of CFA and nonimpaired children, and the changes in these variables over time; 2) To determine the relative power of medical, infant, parent/family, and ecological variables at 2.5 months to predict child competence at 12 and 24 months; 3) To confirm/disconfirm specific hypotheses about group differences at 2.5 months and 12 months, that reflect the importance of overt facial disfigurement in dyadic and social functioning.